As veterans come home, a new generation of caregivers

American troops were serving in both Iraq and Afghanistan five years ago when President Barack Obama signed the Caregivers and Veterans Omnibus Health Services Act, a comprehensive piece of legislation acknowledging the critical role of caregivers for seriously injured post- 9/11 veterans.

The act, signed into law in May 2010, establishes a national program focusing on the wellness and training of family caregivers. It offers caregivers a monthly stipend along with healthcare coverage, training, respite care and mental health counseling through the U.S. Department of Veterans Affairs. The post-9/11 era produced 1.1 million caregivers, about 20 percent of all those caring for veterans.

With advances in combat medicine and technology, more troops are returning after war, but facing devastating physical and psychological injuries.

“This is the longest period of war in U.S. history,” said Steve Schwab, executive director of the Elizabeth Dole Foundation, which works to raise awareness and support for military caregivers. “We are just beginning to learn all the ramifications of that, including what these caregivers are facing. Our national conversation needs to be about the long haul.”

Eligibility for the stipend is evaluated annually and ranges from $650 to $2,300 a month, based on the severity of the injuries and the geographic location of the caregiver and veteran. As of October, more than 22,000 caregivers were participating in the program. For now, it is not open to veterans serving before 9/11.

“Supporting caregivers directly actually impacts the health and wellness of the veterans themselves,” said Margaret Kabat, national director of the VA’s Caregiver Support Program.

In South Florida, about 320 people participate in the program currently, according to Shane Suzuki, spokesman for the Miami VA Healthcare System. The Miami VA also offers general caregiver support groups, with one in the Homestead clinic and a Spanish-language one in Miami.

“Sometimes we find the wife or spouse may end up without support or feeling totally isolated in a civilian world that does not understand the needs of their loved one,” said Martha Corvea, a VA clinical psychologist who has worked with veterans and their families for nearly a decade. “One of the keys is coming together with a group of people who get it.”

In the monthly support sessions, Corvea works to give caregivers coping tools and encourages respite time.

“Our message is you have to have balance,” she said. “When they are away, we want them to disconnect, to really get away, to do something for themselves. It gives them a chance to recharge.”

In 2007, the VA launched about 15 pilot programs for caregivers in communities across the nation.

“When the [Caregiver Act] passed, it was the next step in providing more comprehensive services to caregivers to allow them to continue to take care of those veterans they are already taking care of,” Kabat said, “but to do it in a way that would enhance their health and well-being as well as the health and well-being of the veteran.”

The VA has since partnered with Easter Seals to provide caregiver training in several formats: classroom, workbook and online. So far, more than 2,300 caregivers have taken a course.

Last year, the Elizabeth Dole Foundation commissioned the first evidence-based study focused on the needs of military caregivers. The study, Hidden Heroes, conducted by the RAND Corporation, found that most of the post-9/11 caregivers are young — nearly 40 percent are between 18 and 30 years old — without a lot of financial stability and with no previous training in caregiving. And the commitment is taking a toll: More than one-third meet the criteria for probable depression.

They are taking care of veterans facing many physical and psychological issues: About 20 percent have traumatic brain injury and 64 percent struggle with mental health or substance abuse.

“Our nation has a clear responsibility to better support America’s military and veteran caregivers,” said former Sen. Elizabeth Dole. “This is not a short-term problem in need of a quick solution. . . . Our nation cannot let these caregivers take on this role alone.”

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